Activated protein C resistance due to factor V Leiden, elevated coagulation factor VIII and postoperative deep vein thrombosis in late breast reconstruction with a free TRAM flap: a report of two cases

Thromboembolic complications can endanger free flap surgery and cause postoperative morbidity and even mortality. The underlying cause of thrombosis is multifactorial; major surgery may trigger hereditary thrombophilic disorders leading to overt thrombotic events. This paper reports two cases with postoperative deep vein thrombosis after late breast reconstruction with a TRAM flap. Both showed APC resistance due to factor V Leiden and elevated coagulation factor VIII. One of the patients also had an event of both arterial and venous anastomotic thrombosis postoperatively.